Pandemic or Not?

June 2, 2010

This June marks a year since H1N1 was declared a pandemic by the World Health Organization (WHO). The WHO is currently deciding whether it should maintain H1N1’s status as a "Level 6" pandemic or declare it officially over. Their other option is to declare the pandemic in its "post-peak" phase.

WHO currently defines the most severe grade, or "Level 6," pandemic as "increased and sustained transmission in the general population." At this level, a disease has been transmitted from animals to humans and is spreading on a global scale—beyond localized clusters of people.

The International Health Regulations (IHR) Review Committee is charged with looking back on the actions taken in response to H1N1. At a May 19 press conference, Dr. Harvey Fineberg, chair of the committee, was asked to more clearly define a pandemic.

"The question of the characterization of a pandemic and how the practices about the characterization may have varied over time and for what reasons, all of this is a very important part of the understanding that the committee has to reach," said Fineberg. "Another very important dimension implicit in that and certainly important looking ahead is the question of characterizing severity as well as extent."

The declaration of a pandemic is not to be taken lightly. Before the outbreak of 2009 H1N1, 1968 was the last year WHO made such a proclamation. The level of a pandemic determines what actions will be taken, such as the storage of vaccine and supplies.

The WHO has been criticized of being overly influenced by pharmaceutical companies, ramping up the degree of severity of the H1N1 outbreak in order to boost sales of vaccine. Margaret Chan, WHO director-general, has repeatedly denied these accusations.

Chan announced in April that the IHR Review Committee would take an open, transparent look at the actions taken by the organization concerning H1N1. The committee is made up of science and public health experts from around the world, brought together to analyze the international response to H1N1.

"We are seeking lessons, about how the IHR has functioned, about how WHO and the international community responded to the pandemic, that can aid the management of future public health emergencies of international concern,” said Chan. “And I can assure you—there will be more."

Currently, H1N1 activity is most active in the Caribbean and parts of Southeast Asia. Travelers to the International Association of Federation Football (FIFA) World Cup in South Africa are being urged to protect themselves against "common travel-related illnesses," including seasonal and H1N1 influenza.